Korean J Psychopharmacol.
2000 Jun;11(2):168-177.
Autonomic Nervous System Related Adverse Effects Developed during Clozapine Treatment
- Affiliations
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- 1Department of Neuropsychiatry, Gil Medical Center, Gachon Medical School, Incheon, Korea.
- 2Department of Psychiatry, Eulji Medical Center, Eulji Medical College, Seoul, , Korea.
- 3Department of Psychiatry, Seoul National University College of Medicine, Seoul, , Korea.
- 4Yong-In Mental Hospital, Yong-In, Korea.
Abstract
OBJECTIVE
The purpose of this study is to investigate the prevalence and course of autonomic nervous system related adverse effects (ARAEs) reported in patients treated with clozapine. METHOD: Ninety-one patients treated with clozapine were recruited from the Seoul National University Hospital Treatment-Resistant Schizophrenia Clinic. Medical records were reviewed for the prevalence and course of 14 ARAEs related to clozapine treatment. ARAEs with the prevalence greater than 10 % were selected and analyzed for their relationship with the demographic variables of the subjects and for the distribution of the duration of treatment and daily dosage of clozapine.
RESULTS
Eighty-one(97.8%) patients experienced at least one ARAE during treatment with clozapine. The most frequent ARAE was hypersalivation, followed by constipation, tachycardia, orthostatic hypotension, nausea, diaphoresis, frequency, enuresis, vomiting, blurred vision, dry mouth, diarrhea, incontinence and urinary retention. None of the 7 selected frequent ARAEs had significant relationship with the age or sex of the subjects. Most of them developed within 8 weeks of clozapine treatment and at the dose of clozapine under 200mg/day. Among the total 248 events of ARAEs, 35 events required additional medications to alleviate the symptoms, 8 required other medical interventions, and 3 required reduction of clozapine dose. There was no case which necessitated withdrawal of clozapine therapy.
CONCLUSION
The findings from this study suggest that almost all patients treated with clozapine experienced one or more ARAEs. Most of them occurred during the initial phase of treatment and managed without further medical treatment.
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